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Question: If our pain management doctors have their imaging read on their behalf by a radiologist (using our imaging equipment) and our doctor performs and documents their own independent interpreta... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Like 2024, 2025 was a year of stasis in use and denial of inpatient-or-observation E/M codes. But providers who are called upon to use them should still watch for changes in billing practices from y... More

Ask a Part B News Expert

Question: If our pain management doctors have their imaging read on their behalf by a radiologist (using our imaging equipment) and our doctor performs and documents their own independent interpreta... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Like 2024, 2025 was a year of stasis in use and denial of inpatient-or-observation E/M codes. But providers who are called upon to use them should still watch for changes in billing practices from y... More

Breaking: Final 2027 Medicare physician fee schedule ups pay cuts, ushers in payment modifiers

by: Richard Scott

Tackle 3 cybersecurity priorities now: Expert

by: Richard Scott

CPT 2027 refresh delivers E/M updates, MDM clarity and hundreds of new codes

by: Laura Evans, CPC, Julia Kyles, CPC, and Richard Scott

Payment impact: Codes subject to the final 2027 PFS modifier 25 cut

Provide your staff with a quick guide to the codes that are subject to the modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) pay cut and how the 20% cut affects the average reimbursement for each code.

Update to the list of designated health services – 2026

Find the latest list of designated health services (DHS) that are subject to the Stark physician self-referral rule’s restriction on referrals. The new list went into effect Jan. 1, 2026.

Hospital E/M code use stable; watch billing policies to keep steady

Like 2024, 2025 was a year of stasis in use and denial of inpatient-or-observation E/M codes. But providers who are called upon to use them should still watch for changes in billing practices from year to year.

Leveled up: Level 4, 5 office visit codes continue climb, others crash

The trend in E/M office visit (99202-99215) reporting is perhaps best exemplified in the contrasting fall-and-rise of Level 3 and Level 5 established office visit codes: while total claims for 99213 were down 29% in a recent five-year stretch, those for 99215 increased by the same percentage.

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